In other words, though the immediate impact of the Stupak amendment will be limited to the millions of women initially insured through a new insurance exchange, over time, as the exchanges grow, the insurance industry will scale down their abortion coverage options until they offer none at all.

"As a result, Stupak/Pitts can be expected to move the industry away from current norms of coverage for medically indicated abortions. In combination with the Hyde Amendment, Stupak/Pitts will impose a coverage exclusion for medically indicated abortions on such a widespread basis that the health benefit services industry can be expected to recalibrate product design downward across the board in order to accommodate the exclusion in selected markets."

Furthermore the study finds that the supposed fallback option for impacted women—a "rider" policy that provides supplemental coverage for abortions only—may not even be allowed under the terms of the law. "In our view, the terms and impact of the Amendment will work to defeat the development of a supplemental coverage market for medically indicated abortions. In any supplemental coverage arrangement, it is essential that the supplemental coverage be administered in conjunction with basic coverage. This intertwined administration approach is barred under Stupak/Pitts because of the prohibition against financial comingling."

Now some, like Ruth Marcus, seem to think that again, this isn't a big deal. The most important thing is going to be health insurance coverage, right?

The issue with that stance though is that while we know Stupak-Pitts is fucked-up, we don't know that this reform bill is good. We don't know how they will determine what constitutes affordable and we don't know when this exchange will start bringing costs down, though we may now be penalized for failing to purchase insurance. And to trade a right that was hard-won and continues to be fought for daily for a box of ifs, possibles, and maybes is too high of a price to pay.